中药合方治疗伴重度阻塞性肺通气功能障碍的慢性肺曲霉菌病临床观察  

Clinical observation on the treatment of chronic pulmonary aspergillosis with severe obstructive pulmonary ventilation dysfunction with traditional Chinese medicine combined with prescription

作　　者：李晓颖[1] 曹金钟[2] LI Xiao-ying;CAO Jin-zhong(The Branch of Third Central Hospital of Tianjin,Tianjin 300250,China)

机构地区：[1]天津市第三中心医院分院,天津300250 [2]天津市第三中心医院分院呼吸科,天津300250

出　　处：《中华中医药杂志》2021年第5期3025-3029,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81373849)。

摘　　要：目的:探讨中药合方治疗伴重度阻塞性肺通气功能障碍的慢性肺曲霉菌病的临床有效性及可行性。方法:选择2018年3月至2019年8月就诊于天津市第三中心医院分院的伴重度阻塞性通气功能障碍慢性肺曲霉菌病患者26例,依据就诊时患者的实际情况分为对照组和观察组,每组13例。两组均采用常规基础治疗,对照组在已有的抗曲霉菌药物治疗基础上继续规范化应用;观察组停用抗曲霉菌药物,采用中药合方干预。比较两组治疗前后体质量指数(BMI),呼吸困难指数(mMRC),圣乔治呼吸问卷(SGRQ)评分,肺功能第1秒用力呼气容积占预计值百分比(FEV1%预计值),血清白蛋白(ALB)、尿素氮(BUN)、肌酐(Cr)、总胆固醇(TC)、甘油三酯(TG)水平及外周血淋巴细胞(LY)计数。结果:与本组治疗前及对照组同期比较,观察组治疗后BMI、ALB、LY均显著升高,mMRC及SGRQ评分中呼吸症状评分及总分显著降低(P<0.05)。结论:采用中药合方辨证施治可达到与唑类治疗相近的疗效,甚至在改善患者生活质量及呼吸功能方面可能更具有一定优势。Objective:To explore the clinical efficacy and feasibility of Chinese medicine combined with prescription in the treatment of chronic pulmonary aspergillosis with severe obstructive pulmonary ventilation dysfunction.Methods:A total of 26 patients diagnosed chronic pulmonary aspergillosis with severe obstructive ventilation dysfunction in The Branch of Third Central Hospital of Tianjin from March 2018 to August 2019 were enrolled in our comparative study,according to the actual situation,divided into observation group and control group,13 cases in each group.Both groups were treated with conventional treatment,the control group continued standardized application based on the existing anti aspergillus drug treatment;the observation group stopped using anti aspergillus drugs,ues traditional Chinese medicine combined with prescription intervention.BMI,mMRC,SGRQ,FEV1%,ALB,BUN,Cr,TC,TG,LY of the two groups before and after treatment were compared.Results:Compared with before treatment and the same period in the control group,BMI,ALB and LY were significantly increased in the observation group,mMRC,respiratory symptom score and total score of SGRQ scores were significantly decreased(P<0.05).Conclusion:The therapeutic effect of traditional Chinese medicine combined with syndrome differentiation is similar to that of azoles,it even have some advantages in improving the quality of life and respiratory function of patients.

关 键 词：小陷胸汤 小柴胡汤 养阴清肺汤 慢性肺曲霉菌病 阻塞性肺通气功能障碍 伏立康唑 

分 类 号：R259[医药卫生—中西医结合]